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Philadelphiamedicine.com

PHILADELPHIA INTERNATIONAL MEDICINE® NEWS BUREAU
Contact: Matteo Rascone
215/575-3720;October 27, 2009

For immediate release:
In this month’s edition
1. Penn Studies Point Strategies for Reducing Painful Breast Cancer Drug Side Effects
2. St. Christopher’s Hospital for Children Appoints New Chief of Cardiology
3. Gordon Schwartz, MD, MBA, to Lead Jefferson Breast Care Center
4. Cardiothoracic Surgeon Abeel A. Mangi, MD, Joins Temple University Hospital
Editors note: Research, new techniques and improved facilities by Philadelphia International Medicine hospitals and physicians may lead to
new ways to treat some of our most challenging diseases. Below are just some examples from our hospitals.

PHILADELPHIA – Aromatase inhibitors, the same drugs that have buoyed long-term survival rates among breast cancer patients, also carry side effects including joint pain so severe that many patients discontinue these lifesaving medicines.research has identified patterns that may help clinicians identify these symptoms sooner in order to increase their chances of continuing their treatment regimen. In a study published recently in the journal Cancer, researchers at Penn’ found that during treatment, estrogen withdrawal may play a role in the onset of joint pain, also known as arthralgia. Women who stopped getting their menstrual periods less than five years before starting breast cancer treatment were three times more likely to experience these pains than those who reached menopause more than a decade earlier. In a separate study published in the journal Integrative Cancer Therapies, the Penn researchers found that among women experiencing these symptoms during treatment with aromatase inhibitors (AI), those who received electro-acupuncture—a technique that combines traditional acupuncture with electric stimulation—reported a reduction in joint pain severity and stiffness. Those women also said they ―We are fortunate today to have many effective treatments for breast cancer. Unfortunately, many of these treatments have troublesome and debilitating side effects that can last for months or years after treatment, and really harm the quality of life and productivity of women who receive them,‖ says lead authorssistant professor of Family Medicine and Community Health. ―These findings are just a first step in our comprehensive research program aimed at understanding the nature of treatment-related symptoms, who is likely to get them, the mechanisms by which they occur, Toxicity issues and side effects among patients taking aromatase inhibitors―drugs used in post- menopausal women to prevent recurrence of breast cancer following initial treatment, by reducing the amount of estrogen the body makes―lead as many as 20 percent of patients to miss prescription refills or discontinue their therapy altogether. Patients in the new study were taking aromatase inhibitors including Of the 300 patients enrolled in the study, 139 reported AI-related pain, with 75 percent of those reporting symptoms that began within the first three months of the therapy. Women most commonly had pain in their wrists, hands, and knees, though more than half said they also had pain in their backs and ankles or feet. Women who had their last menstrual period within the five years prior to beginning AIs appeared to be three times more likely to have these symptoms than women whose periods had stopped The authors say this finding indicates that women who entered menopause more recently may have higher levels of residual circulating estrogen in their bodies, which combined with exposure to AIs may cause a steeper, quicker drop in estrogen levels, leading to worse symptoms. Mao and senior authorssociate professor of Medicine and Epidemiology and Biostatistics, are running a comprehensive wellness after breast cancer study to examine how clinical and genetic factors relate to treatment-related symptoms such as joint pain, hot flashes, insomnia, and fatigue both during and after cancer treatment. Ultimately, they hope to identify patients at greatest risk of these symptoms and late effects of treatments, and to personalize therapy in a way that will prevent the side effects of cancer therapy while maximizing the likelihood of cure. ―As modern science brings cures to many women affected by breast cancer, how to help these women to live well after cancer is vitally important,‖ Dr. DeMichele says. ―With a multidisciplinary team of clinicians and researchers from oncology, primary care, reproductive endocrinology, and behavioral health, we will better understand the challenges faced by breast cancer survivors and develop new treatments that promote the health and wellbeing of our patients as they strive to overcome this illness.‖ St. Christopher’s Hospital for Children Appoints New Chief of Section of Cardiology
Shuping Ge, MD, has been named chief of Cardiology at St. Christopher’s Hospital for Children. Dr. Ge specializes in treating pediatric congenital and acquired cardiovascular diseases. His clinical interests include non-invasive imaging, including cardiac ultrasound and other imaging modalities utilized for the diagnosis and assessment of congenital heart defects in fetuses, children and adults. Before he came to Philadelphia, Dr. Ge was a pediatric cardiologist at Texas Children’s Hospital in Houston and an assistant professor of pediatrics at Baylor College of Medicine. He also served as director of the Noninvasive Cardiovascular Imaging Research Center for Heart Failure and Stem Cell Research for the Texas Heart Institute at St. Luke’s Episcopal Hospital, which is affiliated with the University of Texas. He previously served as director of the echocardiography laboratory at the Dr. Ge has a rich background in research focusing on developing, validating, and utilizing three- dimensional cardiac ultrasound for congenital and acquired heart diseases. He has also participated in developing new drug, cell and gene therapies for heart failure. His research has been funded by the American Heart Association, National Institutes of Health and other agencies and industries. Dr. Ge received his medical degree from Shandong University College of Medicine in China. He completed his pediatric training at St. Vincent's Hospital and Medical Center in New York. He completed fellowships in cardiac ultrasound at Oregon Health Sciences University and Wake Forest University in Winston-Salem, NC, as well as a pediatric cardiology fellowship at the University of Colorado Health Sciences Center, Children's Hospital in Denver. Dr. Ge is board-certified in pediatrics and pediatric cardiology and is a fellow of the American Academy of Pediatrics, American College of Cardiology and American Society of Echocardiography. He has lectured nationally and internationally and has published numerous articles and book chapters. He serves on the editorial board of several peer-reviewed journals and is a member of the study section of the ―We are honored that Dr. Ge has joined the staff at St. Christopher’s Hospital for Children,‖ says Bernadette Mangan, chief executive officer. ―Dr. Ge is at the forefront of pediatric cardiology and is highly esteemed by his peers throughout the country and world.‖ Gordon Schwartz, MD, MBA, to Lead Jefferson Breast Care Center
Gordon Schwartz, MD, MBA, has been appointed director of that the Kimmel Cancer Center, and will also return to the full-time faculty as a professor in Jefferson’s Department of Surgery. With more than 40 years of clinical and educational experience, Dr. Schwartz is an internationally renowned expert in breast diseases. Dr. Schwartz has been associated with Thomas Jefferson University and Hospital since 1970 when he was appointed an assistant professor in the Department of Surgery. He rose to the rank of full professor in 1978 and during his tenure he has been the director of Surgical Academic Programs (1970- 80); the director of the Surgical Residency Program (1970-79); and the director of the fellowship in Breast Diseases since 2003. He has been an attending physician at Jefferson since 1970 and has dedicated his practice to treating patients with breast diseases, both benign and malignant. Dr. Schwartz earned his undergraduate degree from Princeton University and received his medical degree from Harvard Medical School. His postgraduate training began as a surgical intern at the New York Hospital-Cornell Medical Center, but his surgical training was interrupted by military service as a surgeon in the United States Army. After his honorable discharge, he completed a residency in surgery at the Columbia-Presbyterian Medical Center in New York City, where he served as chief resident surgeon his final year; and he then served a one year fellowship as a U.S. Public Health Service Cancer Control Senior Trainee at the University of Pennsylvania. In 1990 he earned a master of business administration degree (MBA) from The Wharton School of the University of Pennsylvania. Dr. Schwartz is board certified by the American Board of Surgery and was awarded the AOA Faculty Award for Distinguished Teaching from Jefferson in 1974. He has received numerous citations from Best Doctors in America and is included in numerous editions of Who’s Who in Medicine and Healthcare. The Susan G. Komen Breast Cancer Foundation honored him with their ―Race for the Cure‖ Award in 1996. Dr. Schwartz has served on the editorial boards of such noted journals as CANCER, Seminars in Breast Disease and The Breast Journal, among others; and is a member of the Society of Surgical Oncology, American College of Surgeons, American Society for Clinical Oncology, the American Society of Breast Surgeons, and the American Society of Breast Disease (former president). He has published more than 225 research studies, most in the areas of breast diseases and breast cancer. Cardiothoracic Surgeon Abeel A. Mangi, MD, Joins Temple University Hospital
Abeel A. Mangi, MD, has joined the surgical faculty of Temple University School of Medicine and been appointed surgical director of the Lung Transplant Program and associate surgical director of the Heart Transplant Program at Temple University Hospital (TUH). Mangi was also named director of the Cardiothoracic Transplant Research Laboratory at Temple University. Previously, Mangi was on the professional staff in Cardiothoracic Surgery at the Cleveland Clinic. ―I am delighted that Dr. Mangi has joined the cardiothoracic team,‖ said Satoshi Furukawa, MD, chief of the Division of Cardiothoracic Surgery at Temple University Hospital, in announcing the appointment. ―We look forward to the addition of his expertise and skills to our comprehensive surgical treatment options for patients with lung and heart disease.‖ ―I am eager to expand Temple's clinical and research capabilities to further enhance the care of patients with end-stage lung and heart failure,‖ said Dr. Mangi, who was also named associate director of TUH's Mechanical Circulatory Support Services. ―Providing high-quality, comprehensive care requires a team approach―one involving scores of dedicated healthcare professionals―and I have been very impressed with the caliber and work ethic of the staff associated with both the Heart and Lung Transplant Based on his extensive surgical experience and training, Dr. Mangi hopes to introduce several new devices and protocols to Temple as a means of expanding treatment options for patients. ―I have had considerable success in developing programs that use short-term circulatory support strategies for patients with major heart attacks as well as patients with lung failure,‖ he noted. For example, Dr. Mangi was part of a team of surgeons at New York's Columbia Presbyterian Medical Center that saved the lives of five patients who sustained large heart attacks by using devices created for short-term circulatory support. ―The patients had all suffered massive heart attacks, were in shock, and clinging to life,‖ recalls Dr. Mangi. ―With these devices, we were able to rest both sides of the heart to the point where the heart recovered function―so much so that, upon removal of the device, the patients recovered without the need for transplantation.‖ At the Cleveland Clinic, Dr. Mangi and his surgical colleagues saved two young patients from dying of lung failure by implanting an artificial lung to keep them alive until suitable donor lungs for ―We are hoping to attract companies that make newer Left-Ventricular Assist Devices (LVADs) to Temple, and to participate in upcoming clinical trials so that our patients with heart failure continue to receive top-notch, cutting-edge medical and surgical care,‖ said Dr. Mangi. ―I feel very strongly about the utility of advanced therapies―be they in the form of devices, cell- based therapies, new medical therapies, and transplantation for end-stage heart and lung disease; and that such therapies should be available to all appropriate candidates,‖ continued Dr. Mangi. ―From a societal standpoint, there's no doubt in my mind that patients once thought to be too sick to survive work hard to regain their positions as valuable and robust members of society once they have completed their After earning his medical degree in 1997 from Brown University School of Medicine, Dr. Mangi completed his training in General Surgery at Harvard Medical School and the Massachusetts General Hospital, in Boston. He spent two years performing research in gene and stem cell-based therapies for end-stage heart disease at the Brigham and Women's Hospital, in Boston. He then completed fellowships in cardiac electrophysiology and percutaneous coronary and vascular intervention at Columbia Dr. Mangi then completed his residency in cardiac surgery at Columbia Presbyterian Medical Center, and obtained further training in heart and lung transplantation before being recruited to the Cleveland Clinic, where he specialized in complex, high-risk, and reoperative cardiac surgery, heart transplantation and lung transplantation. Dr. Mangi is board-certified in both surgery and thoracic surgery by the American Board of Surgery and American Board of Thoracic Surgery. He is a member or candidate-member of many professional societies and organizations, including the American College of Surgeons, American Association for Thoracic Surgery, Society of Thoracic Surgeons, American Society of Transplantation, International Society for Heart and Lung Transplantation, and the American Society for Artificial and Dr. Mangi's research interests include stem-cell-based therapies for cardiac repair and regeneration, donor-specific variables influencing heart and lung transplantation, LVADs and platelet dysfunction, and right ventricular dysfunction after cardiac surgery. During the past several decades, Dr. Mangi has earned numerous honors and awards for research advances―including, for three consecutive years, the ―Ruth L. Kirschstein National Research Service Award‖ from the National Institutes of Health (NIH), and the ―New Investigator Award,‖ from the American Heart Association. He also has an international practice and accepts new patients. Philadelphia International Medicine is an organization that provides medical and patient support
services to international patients. It also provides continuing medical education and health care training and education to international physicians, administrators and other practitioners. PIM is owned by the Fox Chase Cancer Center, Pennsylvania Hospital, Temple University Hospital, Thomas Jefferson University Hospital and the University of Pennsylvania Medical Center. It holds affiliation agreements with the Alfred I. duPont Hospital for Children and St. Christopher’s Hospital for Children, and Kennedy University Hospitals. As the international department of several Philadelphia-area hospitals, international patients gain access to physicians and hospitals rated among the best in the world through one telephone call. You can reach PIM by calling 1-215-563-4733; fax, 1-215-563-2777; or e-mail, physicians@philadelphiamedicine.com. You can find out more about PIM through its Website at

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